The invention relates to a combined tool for enabling the surgeon to bring both electrical cauterizing and irrigation functions to a relatively small region of surgical operation, as when surgically entering a lens capsule in the course of a cataract-removal operation.
In such cataract-removal surgery as to which I am informed, it has been the practice to employ a sharp instrument to locally tear the anterior wall of a natural-lens capsule, in order to gain access for insertion of a second instrument to remove cataracted lens material. The sharp instrument has been a conventional hypodermic needle with a conventionally sloping truncated tip, and the instrument has been fashioned by the surgeon himself, by bending the tapered end of the tip into a right-angle bend, thus forming a pointed hook, for scraping, piercing and locally tearing the anterior wall of the capsule. Once sufficient access is thus gained, the second tool is inserted, to bring circularly cut straight ends of concentric tubes into the region of cataracted lens material; one of the tubes is supplied with a flow of irrigating fluid while the other is under reduced evacuation pressures to remove both the irrigation fluid and the severed lens material entrained therewith. In some cases, the second tool includes an ultrasonic element to emulsify the lens material for easier extraction via the evacuating return flow of the irrigation.
Whatever the technique, to my knowledge, there is no means other than cutting or tearing, for removal of the anterior wall of the lens capsule. And this fact has presented difficulties to the surgeon who opts to install an intraocular lens within remaining confines of the lens capsule, in accordance with either of the operative procedures described in my copending patent application Ser. No. 127,450, filed Mar. 5, 1980. For such procedures, it is highly desirable to achieve relative uniformity, circumferential continuity and tissue integrity at the region of the capsule rim through which the implanted lens (including associated haptic structure) is operatively inserted and upon which reliance is placed for stabilized lens retention via the haptic structure.